Tuesday, May 29, 2012

Two Weeks of Chemo: Day 5

This is part of an ongoing two-week series. For more info, see this introductory post.

Unsurprisingly, Day 5 takes up where Day 4 left off: gradually decreasing nausea and a lingering bad taste in my mouth. As there is not much else to say about that, I will spend my post today writing about the port implant through which my chemo medications are infused.

Some chemo meds are vesicants. These chemicals can cause severe burns if they escape the vein. Over the extended course of a typical chemo regimen, these medications can cause chemical burns even when injected properly. To avoid damage to the injection site tissue, some people (such as myself) opt to have an implantable port placed in their chest to provide direct access to larger, stronger veins near the heart. Essentially, a port combines the easy access of the veins in the arm with the blood volume and resilience of the major veins near the heart.

The surgery is fairly minor. It takes less than an hour and is performed under local anesthesia. The main incision is about 3 cm (1.25") with several other guide holes made to properly place the port and thread the catheter. The catheter moves directly under the skin up to the clavicle and then enters the subclavian vein before turning south into the vena cava toward the heart.

Yes, this is my actual x-ray. See the catheter loop up to the clavicle then
back down toward the heart.
Once everything is placed, the surgeon inserts one of the special needles used to access the port, to test that it does in fact have good venous access. This needle is then often left in for the first treatment which can be immediately after the surgery or within the next couple days.

Minor though this surgery was, it made my first treatment "weakend" quite miserable. Recovering from even an admittedly minor surgery while undergoing chemo is no walk in the park. That being said, one of my fellow Hodgkin's lymphoma patients couldn't have the port placed before the first few treatments and I saw the pain that the standard IV injections can cause. In the long run, the port was definitely worth the initial pain. Another bonus is that, because there is so little tissue between the port and the surface of the skin, the needle stick is essentially painless.

Still, I do feel rather bionic at times. The port and catheter have some degree of free movement under my skin and it still weirds me out to see them move as I move. Below is a video of my port and incision site as of today. Hopefully you can get some feeling for how it moves under the skin.

Back to Day 4.
Ahead to Day 6.


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